Background information

The settings approach to improving, protecting and promoting health acknowledges the influence of the setting, eg hospital, school or workplace, in which people live, learn, work and use different services, while recognising the relationship between the organisation and personal factors. Policy direction for this approach stems from Investing for Health, the public health strategy for Northern Ireland.

The hospital provides a vital setting in which the health of staff, patients and the wider community can be promoted. Using the hospital as a setting for the promotion of health means that a hospital can incorporate into its culture, and daily work activity, actions which are designed to ensure that people’s health is promoted and protected as well as treating their ill health.

The concept originated through the work of the World Health Organization (WHO) in 1986 and has developed in Northern Ireland since 1996. As major employers, hospitals are ideally placed to lead in becoming healthy organisations that influence the working conditions of staff. As centres of medicine and care, research and professional development, hospitals influence a wide range of health professionals, other health organisations and the general public.

Since the WHO regional network of health promoting hospitals in Northern Ireland began with a pilot initiative in Altnagelvin Hospital, 13 hospitals are now part of the network, and there has been a real commitment to the development of hospitals as healthy settings. The Health Promoting Hospitals Network has enabled participating hospitals to learn from and support each other in this work, and has proposed the need for a strategy to further develop support and investment.

The Health Promotion Agency for Northern Ireland has appointed Barbara Porter who in her role as coordinator of the programme will develop the policy, information, training and research needed to enhance and drive the programme forward. In relation to the promotion of health in hospitals she will work with hospitals across Northern Ireland to assist them in recognising their potential as key drivers for health improvement with their staff, patients, visitors and the wider community.

Investing for Health

A steering group is being established to develop a regional strategy that will aim to give direction and purpose to promoting health in both the broad health and social services settings and within the hospital setting while embracing existing policies, strategies, priorities and investment. The Agency has been commissioned by the Investing for Health Team at the DHSSPS to facilitate this group.

A healthy service - supporting health in hospitals

As providers, commissioners and employers, the potential of the health and social services to impact positively on people’s health is enormous. This has been recognised in the Investing for Health strategy through a framework for action to improve health and wellbeing and reduce health inequalities by creating 'supportive environments’ for health. The hospital sector is one area of our health and social services structure which is a community resource with a huge reach of influence. The potential exists therefore to create an environment that promotes the health of patients, and those who work in and visit hospitals taking part in the HPA's programme 'A healthy service'.

The aim is to extend this ethos, through existing and new networks, into action for health among other health services and facilities in the community. The HPA programme of support for health in hospitals is set within this framework. Barbara Porter, as coordinator of the programme, has made links with counterparts in England and Scotland with a view to future collaboration in the areas of information sharing, training and research. “While we are beginning this programme of work in hospitals, we are learning more about the potential to extend it across the whole of the health service, and look to the future.” she said.

Phase 1 of the programme 'A healthy service - supporting health in hospitals' included the collection of information on existing health improvement activity in hospitals through a mapping exercise which was completed in April 2005. The information gathered was compiled into a database accessible here.